Lapatinib therapy for patients with advanced renal cell carcinoma
1Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH 44195, USA. rinib2@ccf.org
Abstract:
Lapatinib is an oral dual inhibitor of EGFR and HER2, the coexpression of which is associated with metastatic disease in patients with renal cell carcinoma. A recent randomized phase III trial of lapatinib versus hormone therapy was conducted in patients with cytokine-refractory metastatic renal cell carcinoma and tumors overexpressing EGFR and/or HER2. The study included 416 such patients who received either lapatinib (n = 209) or hormone therapy (n = 207). No benefit in time to progression, which was the primary end point of the study, or other clinical outcome measures, could be demonstrated for lapatinib therapy. A nonsignificant numerical advantage in time to progression was observed in patients with EGFR overexpression in the primary tumor (immunohistochemistry score 3+), suggesting that lapatinib could be of benefit in this subset of patients. This commentary emphasizes the need for further prospective studies to demonstrate the benefit of lapatinib therapy in patients with metastatic renal cell carcinoma.
Insights
Lapatinib did not improve outcomes for metastatic renal cell carcinoma patients overexpressing EGFR/HER2. Further studies are needed to confirm potential benefits in a subset with high EGFR expression.
Area of Science:
- Oncology
- Pharmacology
Background:
- Metastatic renal cell carcinoma (mRCC) often involves coexpression of EGFR and HER2.
- Lapatinib, an oral dual inhibitor of EGFR and HER2, was investigated in this patient population.
Discussion:
- A phase III trial compared lapatinib to hormone therapy in 416 patients with cytokine-refractory mRCC and EGFR/HER2 overexpression.
- The primary endpoint, time to progression, and other clinical outcomes showed no significant benefit for lapatinib.
Key Insights:
- A non-significant trend suggested potential benefit in patients with primary tumors overexpressing EGFR (IHC score 3+).
- This indicates a possible subset of patients who might respond to lapatinib therapy.
Outlook:
- Further prospective studies are crucial to validate the efficacy of lapatinib in specific mRCC patient subsets.
- Investigating targeted therapies based on specific biomarker expression remains a key area in mRCC research.
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